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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
UNITED STATES: Cost-Effectiveness Analysis of Chlamydia trachomatis Screening via Internet-Based Self-Collected Swabs Compared with Clinic-Based Sample Collection
Wei Huang; Charlotte A. Gaydos; Mathilda R. Barnes; Mary Jett-
September 22, 2011
Sexually Transmitted Diseases Vol. 38; No. 9: P. 815-820

CDC recommends population-wide screening for the STD chlamydia among sexually active women younger than 26. Less than half these women, however, are routinely screened. In 2004, the website (IWTK) was introduced to promote at-home sample collection.

In the current study, a decision tree was created to model a hypothetical cohort of 10,000 women per year who order a chlamydia screening kit from the Internet. The researchers compared the incremental cost-effectiveness of two screening approaches: self-sampling via the IWTK website; and traditional, clinic-based screening by the same cohort of women who used the site. For each node in the decision tree, probabilities and costs were estimated. The estimates were derived from primary data, published data, and unpublished health data.

Compared to the clinic-based screening strategy, the Internet- based approach prevented 35.5 more cases of pelvic inflammatory disease, and it saved an additional $41,000 in direct medical costs.

"Our model estimates demonstrated that an Internet-based, self-swab screening strategy was cost-effective compared with the traditional, clinic-based screening strategy," the authors concluded. "Assuming that the popularity of the use of the Internet as a resource for information about health care and sexually transmitted infections leads to an increased use of IWTK, the public health benefit of this cost-effective strategy will be even greater."